Vitamin D Deficiency and Pain in the Loin Region

Deficiency of vitamin D has been linked with many musculoskeletal manifestations, loin pain being one of the most unconventional ones. It is mostly caused due to weakenedmuscles and chronic pain in the flank. It is thus imperative to analyse the problems associated with the skeletal muscles before confirming loin pain as a result of renal complications.

Pain in the Loin Region

The spectrum of diseases that present with loin (flank) pain is wide. It includes kidney and ureteric stone, pyelitis, pyelonephritis, peri-nephric abscess, cystitis, salpingitis, paoillary necrosis, ureteric obstruction by either structure, blood clot, neoplasm or retroperitoneal fibrosis. Cystic diseases of the kidney together with neoplasms are other causes of dull aching loin pains. Trauma and infarction of the kidney cause acute loin pain while vesicoureteric reflux represent one of the causes of long term loin pain that usually exaggerates during the act of micturition.

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Kindle the Spindle: To Bring in Light a Rare Case of Eyelid Spindle Cell Sarcoma

A seventy-five year old female, resident of Mandor village, Jodhpur, presented with complaints of severe pain in right eye and right sided headache for 2 months. She had a history of cataract surgery with IOL implantation in bag in right eye 4 months back in a rural camp setting.

Eyelid Spindle Cell Sarcoma

During the same time, a mass lesion was also removed from underside of right lower lid which was present for about 7-8 years and was sent for histopathological examination. It was reported to be a low-grade spindle cell sarcoma. The tumor was mentioned to be devoid of any surgically free margins except for lateral margins and there was lack of circumscription of tumor mass. The patient was referred to AIIMS, Jodhpur. She deferred the visit initially citing the gain in vision in right eye following cataract surgery to be very gratifying.

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Awareness of Social Media and Health Care

The role of health care providers in maintaining patient privacy and confidentially was first discussed in the Hippocratic Oath over 2,500 years ago. Many of the basic tenants of the Hippocratic Oath, including the respect of patient privacy and confidentiallywas adopted by Lystra Gretter in 1893, author of the Nightingale Pledge.

Today the American Nurses Association's statement on the ethical and legal obligation to protect the privacy and confidentially of their patients remains in align with the Hippocratic Oath and the Nightingale Pledge. Communication is a major part of a human being’s social life. Human being’s communicating for multiple reasons. Human beings communicate in an attempt to influence another’s thoughts or beliefs, to exchange information, to seek information and to express feelings and emotions.

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Envisioning Vision: Journal Clusters in Ophthalmology

To bring disciplines such as ophthalmology into sharper focus, it is possible to visualize the connections among the refereed journals in this field. Using citations as representing connective tissue, one can delineate what are called epistemiccommunities or knowledge networks that constitute a discipline of science.

Ophthalmology

The connections, when drawn as a network of links created by citations among journals, provide a visual, statistical, and cultural exploration of scholarly communication. This brief perspective presents this analysis for ophthalmology. For more than three centuries; refereed journals (exemplified in this analysis by Eye or Retina) have gathered together articles on scientific subjects.

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Tear and Pterygium: A Clinico-Pathological Study of Conjunctiva for Tear Film Anomaly in Pterygium

Pterygium remains an oblivious dilemma except for its unanimously accepted description as a triangular, fibro-vascular sub-epithelial in-growth of degenerativeconjunctival tissue encroaching onto the cornea.

Pterygium

Although environmental factors appear to be the dominant cause, tear film abnormalities are also incriminated in its theories of aetiopathogenesis. Pterygium has preponderance in Agra with prevalence varying between 15-20 %. Agra features a semi-arid, subtropical climate, providing ideal conditions for studying tear film abnormalities in pterygium. Pterygium justifies the adage “prevention is better than cure” and it becomes pertinent that we evaluate the status of tear film so as to find effective, documentable, time-efficient, and preferably non-invasive tools for detecting early tear film abnormalities and suggest remedial measures.

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The Dropped Brow Sign in Psychogenic Pseudo-Myasthenic Ptosis

In patients presenting with eyelid ptosis the clinician considers a differential diagnosis of 3rd nerve palsy, Horner’s syndrome, mitochondrial myopathy, oculopharyngealmuscular dystrophy, levator dehiscence, myotonic dystrophy and myastheniagravis.

Dropped Brow Sign

The presence of moment to moment fluctuation in severity of ptosis (fatigable ptosis) typically suggests a neuromuscular junction disorder of which myasthenia gravis is the only common form. Patients may also present with symptoms or signs that are psychological in origin. We present a case of ptosis associated with the “dropped brow sign” (initially misdiagnosed as myasthenia gravis). This finding is evidence for psychogenic pseudo-myasthenic ptosis and should direct the clinician towards early exploration of a psychological component to the patient’s symptoms. 

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A Case of Left Ventricular Pseudoaneurysm

Left ventricular (LV) pseudoaneurysm is a catastrophic complication of acute myocardial infarction that is reported in less than 0.1% of patients. It is caused by myocardial rupture contained within the pericardium and ischaracterized by the absence of true myocardial tissue in its wall unlike, a true aneurysm which involves the full myocardial wall thickness.

Pseudoaneurysm

The non-specific clinical presentation of such condition is what makes its diagnosis a clinical challenge. Early diagnosis is mandatory using noninvasive modalities such as TTE and CMR or less commonly used nowadays invasive modalities such as coronary arteriography and left ventriculography. Due its high liability for fatal rupture urgent surgical intervention is of paramount importance in management of this pathology.

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Dry Eye Symptoms in Wet Eyes

Evaporation is a ubiquitous threat to the quality of the tear layer surface that serves as the most powerful focusing lens of our eyes. Sustaining this function in face of the omnipresent threat of its evaporative degradation was a major obstacle to the migration of our remote ancestors from their water habitat to land.

Dry Eye Symptoms

The development of a tear thickness-monitoring alarm/ tear secretion system was a key factor in the evolution of our species.Conventional wisdom attributes the dry eye-like symptoms of eyes with adequate tears to their accelerated evaporation. However, observations that the volume of tears is too generous and the Meibomian glands are normal in some of these patients question this belief and suggest the participation of an important and still unidentified pathogenic mechanism.

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Gene Expression Monitoring in Pediatric Heart Transplant Recipients

Rejection is a leading cause of morbidity in pediatric heart transplant recipients, often through progression to graft failure and death. In the most recent era, 15% of patients experienced treated rejection within the first yearpost-transplant, with rates of rejection being highest in patients greater than 1 year of age.

Pediatric Heart Transplant

Frequent monitoring with cardiac catheterization and endomyocardial biopsy (EMB) has been utilized to monitor patients in the post-transplant period for evidence of rejection. However, EMB has been associated with risks such as tricuspid valve damage and regurgitation, conduction system abnormalities, and cardiac perforation. Endomyocardial biopsy is subject to sampling error and inter-observer variability, and can only detect acute cellular rejection (ACR) once cellular infiltration and damage has occurred.

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Heart Murmur among Lebanese Children: A Retrospective Study to Evaluate Epidemiological Features and Risk Factors

A heart murmur is a continuous sound that is audible with a common stethoscope, produced by turbulent blood along its passage through heart cavities. Often heart murmurs are innocent and do not underline a structural lesion.Heart murmurs are so frequent and touch almost80% of neonates and 1/3 of infants and children.

Heart Murmur

Therefore, it shall remain the chief cause of consultation in pediatric cardiology clinics. Congenital heart diseases (CHD) are also known for their high prevalence with an incidence reaching 0.5 to 0.8%; most cases being diagnosed during infancy and accounting only 1 to 2/1000 cases in school-aged children later on.Innocent heart murmurs are isolated murmurs with no other clinical or historical findings and no underlying structural cardiovascular disease.

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Retina and Schizophrenia

Schizophrenia is a complex chronic mental disorder, which affects 24 million people worldwide and is responsible for significant functional impairment. Several studies have tried to understand this disease and the involvement of the central nervous system. Neuro-imaging studies have shown structural brain changes inschizophrenia, already evident in the first psychotic episode. It is essential to realize how the neurodevelopment and the neurodegenerative domains influence this disease.

Retina and Schizophrenia

In our manuscript, entitled "Evaluation of Structural Changes in the Retina of Patients with Schizophrenia", we try to understand how a non-invasive exam, as Optical Coherence Tomography (OCT), can also be useful in schizophrenia, to evaluate the thickness of the retinal nerve fiber layer (RNFL) and macular volume and thickness. In the second part of this study, we try to realize the correlation of these data with cognitive functioning in schizophrenic patients, abstract previously published (entitled “Correlation between macular OCT and cognitive function in patients with schizophrenia”).

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The Importance of Incorporating Technological Advancements into the Prosthetic Eye Development: A Perspective Commentary

Application of technology into healthcare has typically been targeted to high demand illnesses and treatments.

Services have historically been led by skills and expertise, and recent developments are being seen by ocularists in the field of prosthetic eyes who acknowledge the potential benefit from technological advancement.

Utilising the technologies recently investigated in maxillofacial prosthesis can start the evolutionary process where products are continually re-designed and re-developed to achieve excellent patient outcome and satisfaction levels.

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